Loading
Get The State Of Wisconsin Application - Dean Health System
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the The State Of Wisconsin Application - Dean Health System online
This guide provides detailed instructions on how to complete The State Of Wisconsin Application for Dean Health System online. Whether you are a first-time applicant or are familiar with health insurance applications, this guide will assist you in successfully submitting your application.
Follow the steps to complete your application accurately and efficiently.
- Click ‘Get Form’ button to access the application form and open it in your browser.
- review the eligibility criteria. Ensure you meet the requirements of being a U.S. citizen or resident legal alien aged 18 to 64 and residing within the Dean Health Plan service area.
- provide your personal information. Fill out your full name, social security number, place of birth, birth date, gender, height, weight, residential address, and contact details. If you are applying with dependents, include their information as prompted.
- accept the terms related to medical information disclosure. Acknowledge that your healthcare information may be requested as part of the underwriting process.
- input your employment details. Specify your primary job duties, indicating whether you are self-employed.
- disclose any current or previous health coverage. Indicate whether you or any dependents currently have health coverage or had coverage in the last 18 months.
- complete the medical information section. Carefully answer questions regarding any medical conditions, treatments, or medications received in the last five years.
- select your plan options. Choose your desired health plan and any optional riders within the application.
- sign and submit your application. Ensure all required signatures are provided and print or save the completed application for your records before submission.
- after submission, monitor your email or phone for communication from Dean Health Plan regarding your application status and details regarding final rates.
Begin filling out your application online today to ensure timely coverage!
Last year, Minnesota-based Medica acquired 55% of Madison-based Dean Health Plan for $232.7 million, ing to a Wisconsin State Journal report. The details of the sale completed on Dec. 1, 2021, were recently made public.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.